Provider Demographics
NPI:1194046011
Name:SOCIE, ANASTASIA MARIE (MA/CAS, NCSP)
Entity Type:Individual
Prefix:MRS
First Name:ANASTASIA
Middle Name:MARIE
Last Name:SOCIE
Suffix:
Gender:F
Credentials:MA/CAS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 BONNYBROOK RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-1636
Mailing Address - Country:US
Mailing Address - Phone:252-412-7418
Mailing Address - Fax:
Practice Address - Street 1:945 FOREST ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3401
Practice Address - Country:US
Practice Address - Phone:302-672-1500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE47744103TS0200X
NC103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool